Laparoscopic versus open surgery for rectal cancer: a meta-analysis of 3-year follow-up outcomes

Int J Colorectal Dis. 2016 Apr;31(4):805-11. doi: 10.1007/s00384-016-2506-9. Epub 2016 Feb 4.

Abstract

Purpose: We wished to evaluate the effectiveness of laparoscopic and open surgery for patients with rectum cancer through a meta-analysis.

Methods: We searched PubMed, EMBASE, and Cochrane database until June 30, 2015, to identify eligible studies. Randomized controlled trials comparing laparoscopic with open surgery for rectum cancer were included. Meta-analysis was performed using the search strategy following the requirement of the Cochrane Library Handbook. Three-year overall survival (OS) and disease-free survival (DFS) were the main endpoints.

Results: Eight randomized controlled trials comprising 3145 patients matched the selection criteria. Meta-analysis showed no significant difference between laparoscopic and open surgery in 3-year overall survival (OS) and disease-free survival (DFS) (hazard ratio (HR)3-year OS = 0.83, 95 % CI [0.68-1.01]; P = 0.06; HR3-year DFS = 0.89, 95 % CI [0.75,1.05]; P = 0.16). No evidence of publication bias was observed.

Conclusion: Our meta-analysis supported the notion that based on the 3-year DFS and OS, oncological outcomes are comparable after laparoscopic and open surgery for rectal cancer.

Keywords: Laparoscopy; Meta-analysis; Open surgery; Rectum cancer; Survival rate.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Aged
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Publication Bias
  • Randomized Controlled Trials as Topic
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / surgery*
  • Survival Rate
  • Treatment Outcome